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Neuro Exam 2 > Assessing Cognition > Flashcards

Assessing Cognition Flashcards

1
Q

Nature and severity of the cog-comm impairments are determined largely by…

A
  • location of injury

- severity of injury

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2
Q

(location) Cortical injuries are more likely to affect…

A

higher-level processes that are subcortical injuries

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3
Q

(location) Frontal lobe injuries characteristically cause problems with…

A

initiation and regulation of purposeful behavior

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4
Q

(location) Posterior language dominant hemisphere injuries cause problems with…

A

comprehension and production of language

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5
Q

(location) Posterior non-language-dominant-hemisphere injuries cause problems with…

A

affect, interpersonal behavior, and attention

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6
Q

(severity) loss of large amounts of brain tissue result in what?

A

deficits in attention, perception, and higher-level processes such as language, reasoning, and abstract thinking

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7
Q

(severity) localized or patchy injuries will have higher-level processes but not…

A

impairments of basic processes

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8
Q

Sorting through a patient’s collection of impairments and retained abilities requires… (5)

A
  • patience
  • persistence
  • logic
  • intuition
  • carefully chosen reliable tests
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9
Q

Define focused attention

A

basic response to stimulation

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10
Q

Define sustained attention and describe how you would assess this

A
  • (aka vigilance) attention maintained over time
  • Assessed with strings of computer-presented auditory or visual stimuli is presented over relatively long and purposely monotonous intervals. Pt is instructed to indicate when she/he perceives the stimuli
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11
Q

Define selective attention and describe how you would assess this

A
  • attention maintained in the presence of competing or distracting stimuli
  • Assessed with cancellation tasks with increasing difficulty
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12
Q

Define alternating attention and describe how you would assess this

A
  • attention shifted from one stimulus to another in response to changing task requirements or person’s changing intent
  • Most tests of alternating attention are sustained attention tests in which response requirements periodically change (e.g., cancellation task in with a new target designated for each line)
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13
Q

Define divided attention and describe how you would assess this (2 forms)

A
  • attending to more than one activity concurrently (driving a car while talking on the phone)
    1. Pt retains information in memory while performing mental operations on the information (digits backwards, counting backward by 2s, 3s, 4s, or 5s, saying letters/words alternatively in sequence, a-1-b-2-c-3. Requires “working memory”
    1. Dual Task Form – Pt performs two concurrent tasks. E.g., listens to a tape recording and says “yes” whenever she/he hears a designated letter
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14
Q

What else would you be assessing for attention?

A

alertness- indirectly assessed during interviews, via reports from others, during assessment

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15
Q

Alertness- reaction time measures what?

A

time between the onset of each stimulus and the pt’s response

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16
Q

What test is an ecologically valid test of attention?

A

Test of Everyday Attention (TEA)

pg 85

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17
Q

T/F Some researchers have argued that standard tests of attention are highly structured and are not sensitive to impairments that may be present in less structured daily life environments

A

true

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18
Q

Impaired memory is an important consequence of ____

A

Brain injury (BI)

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19
Q

Models of Memory:

Divide memory into two stages of _____ and one stage of _____

A

short term (ST) storage, long term (LT) storage

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20
Q

Models of Memory:

Name the 3 stage models

A
  1. Sensory register or sensory memory
  2. Immediate memory
  3. Long-term memory (or secondary memory)
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21
Q

Models of Memory:

First stage

A
  • mental space where incoming info is retained in modality-specific form ( aka registration)
  • system has limited capacity and the contents decay within 1-2 seconds
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22
Q

Models of Memory:

T/F information at stage 1 can be “rehearsed”

A

false

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23
Q

Models of Memory:

Second stage

A
  • limited capacity
  • info in immediate memory decays with a few seconds unless rehearsed
  • may be quantified as retention span
24
Q

Rehearsal enables an individual to…

A

maintain info in memory for intervals from minutes to hours

25
Q

What is retention span?

A

number of items of discrete info can be held in immediate memory at one time

26
Q

Models of Memory:

Third stage

A
  • very large (infinite) capacity
27
Q

Contemporary cognitive science has replaced concept of immediate memory with _____

A

working memory

28
Q

T/F recent and remote memory categories cannot be separated in adults without BI

A

true

29
Q

T/F persons with dementia have decent memory of recent events and poor memory of events from childhood and growing-up years

A

false; they have no memory of recent events and accurately remember events from childhood and growing-up years

30
Q

List the types of retrospective memory

A
  • declarative: episodic and semantic memory
  • procedural memory
  • prospective memory
31
Q

Define declarative memory

A

what we know about things

32
Q

Define episodic memory

A

memory for past events that are specific to a time and place

33
Q

Define semantic memory

A

organized knowledge of the world, especially knowledge gained in school

34
Q

Define procedural memory

A

knowing how to do things

35
Q

Define prospective memory

A

remembering to remember

36
Q

How would you assess retention span?

A

digit span testing

37
Q

How would you assess remote memory?

A

personal information- name, birthday, phone number, address, education level

38
Q

How would you assess visual memory?

A

display geometric designs and ask the pt to draw the design from memory

39
Q

How would you assess prospective memory

A

Rivermead Behavioural Memory Test (pg 91)

40
Q

Executive functioning skills includes…

A
  • initiating intentional behavior
  • planning behavioral routines to accomplish intentions
  • maintaining and regulating goal-directed behavior
  • monitoring and modifying behavior in response to situational variables
41
Q

Describe characteristics if severe-profound injury to executive functioning

A
  • may sit alone in a room and stare at wall
  • watch TV from morning to night
  • wander aimlessly from room to room
  • eat only if food is prepared and set in front of them
42
Q

Describe characteristics if less severe injury to executive functioning

A
  • do not perform activities requiring planning and LT goals (shopping, home maintenance, driving, managing meds)
43
Q

T/F for mild injury to executive functioning, SOs/family members may consider them lazy, obstinate, noncompliant

A

true

44
Q

What happens for resource allocation?

A
  • limited pool of resources to perform mental operations
  • any mental operation draws from the pool of resources
  • more complex mental operations draw more resources than less complex tasks
45
Q

Resource allocation: what may happen if demand for resources exceeds the resources available?

A

some mental operations may be slowed, shut down, or performed inefficiently and performance is negatively impacted

46
Q

T/F Most standard tests of cognition and communication are sensitive to impaired executive functioning

A

false; most are not sensitive

47
Q

Describe response flexibility

A
  • may have no difficulty initiating, but have difficulty inhibiting, modifying or stopping behavior once begun
  • difficulty adapting their behavior to changing tasks or response requirements
48
Q

Impaired response flexibility may be indicative of _____

A

perseveration

49
Q

What types of tests would you use to assess executive functioning?

A
  • planning/cancellation tests
  • trail-making tests
  • maze tests
  • connect the numbers/letters tasks
    (pg 95)
50
Q

What types of tests would you use to assess reasoning?

A
  • reasoning and judgment tests
  • verbal and picture absurdities
  • logical relationship tests
  • arithmetic word problems
  • block counting tests
  • visuospatial reasoning tests
  • problem solving
  • abstract thinking - proverbs
51
Q

What are the emotional and psychological effects of BI on cognition?

A
  • self-doubt
  • emotional lability
  • concreteness
52
Q

Emotional and psychological effects: describe self-doubt

A
  • do not trust their perceptions and doubt their ability to handle changes
  • hesitation, indecisive and slow to respond when they feel challenged or threatened
  • withdraw socially
53
Q

Emotional and psychological effects: describe emotional lability

A
  • exaggerated swings in emotional expression

- low frustration tolerance

54
Q

Emotional and psychological effects: describe concreteness

A
  • failure to appreciate the abstract or implied meaning of events, situations, language or visual images
  • fail to appreciate/understand figurative language
55
Q

T/F no standard test battery assesses the full array of BI adults’ cognitive function

A

true

56
Q

Assessment typically involves…(3)

A
  • attention
  • memory
  • executive function
57
Q

_____, ______, and ______ are combined to provide a comprehensive representation of a BI patient’s current strengths and weaknesses in attention, memory, and executive function

A

objective test results,
structured observations, and
subjective impressions

Neuro Exam 2 (4 decks)

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